Brachialgia: It’s A Real Pain In The Neck
Simply put brachialgia is a medical term used to describe a type of arm pain resulting from a compressed or “pinched nerve
” in your neck. It is similar in many ways to the more commonly known condition of sciatica
which causes leg pain from similar origins of a pinched nerve (however, with sciatica the nerve is frequently being “pinched” this time in the lower back not the neck).
Brachialgia Could Be Described As Being The Lesser Know Sibling Of Sciatica
The terms sciatica and brachialgia are used to describe nerve pain in the leg and in the arm respectively. Characteristically descriptive words used to label the feeling that nerve pain creates include “burning”, “gnawing”, “deep aching”, “shooting”, “electric shock…” Frustratingly for those suffering, nerve pain typically does not respond overly well to “normal” over the counter pain killers and frequently persists seemingly relentlessly for days or weeks. Sciatica is pain caused as a result of pinching, pressure or damage to the sciatic nerve, which is the large nerve formed by a combination of smaller nerves exiting the lumbar spine and the section of spine below that called the sacral spine. Brachialgia is the exact analogy of sciatica, however, refers to pain felt in the shoulder, arms, and hands. The associated pain of brachialgia can start as high as being felt in the neck (and sometimes the head) with many patients we see in our physio practice complaining of brachialgia type pain will have severe unremitting pain in the region of their shoulder blade.
Your spine has bony tunnels that contain the spinal cord and the spinal nerves. Should something happen that reduces the diameter of one of these “tunnels” then the spinal cord, or spinal nerves may become “pinched”. This pinching of the nerve through a compromised tunnel is referred to as neural compression and has the potential to causes several different symptoms.
Symptoms may commonly include pain in the neck
, pain referred into the shoulder blade or the arm, and may be associated with weakness in the upper limb and/or a sensation of tingling or numbness into the arm or hand.
Some Potential Causes Include:
Both sciatica and brachialgia can be caused by irritation or damage to the spinal nerve roots or the nerve sheath surrounding the nerve roots. Generally this irritation occurs “inside” the spine but occasionally comes from just outside the spine. Brachialgia can be brought on by any of the conditions, or combination of the conditions listed below. These conditions can all negatively impact the size of the tunnels the nerves travel in. When the size of these tunnels is reduced, there is effectively less room for the spinal nerves and/or spinal cord to coexist happily in the tunnel and as a result, pressure may be placed on the nerve sheath and or nerve root. Some common conditions include:
• Spinal stenosis
• Excess bone growth causing bony spurs (osteophytes) near the tunnels that contain the nerves.
• Osteoarthritis of the spine (spondylosis).
• Degenerative disc disease, as well as bulging, or prolapsed intervertebral discs.
• Spondylolisthesis (the forward displacement of one vertebra on another).
• Spinal cancer
Physiotherapy Treatment And Brachialgia
Physiotherapy treatment can be used to help provide pain relief and assist the recovery process. Depending on individual requirements, physiotherapy treatment may include:
• Mobilisation and manipulation of the spine and associated soft tissues.
• Targeted strengthening and stretching exercises.
• Postural retraining
• Advice around activity modification (including ideas around ways to modify your workplace and recreational activities, to avoid strain via lifting and repetitive neck or arm movements and positions).
Pain medication frequently plays a substantial role in helping to manage brachialgia, as it is typically a very painful condition. You may be prescribed some powerful painkillers
by your doctor or treating specialist to help manage the discomfort. A combination of good pain management and physiotherapy is frequently very effective in treating brachialgia without the need for injections or surgical intervention.
Surgery And Brachialgia
In some situations, more invasive approaches are required, one such approach it the use of nerve sheath injections being used to offer additional pain relief. These injections can greatly improve any pain associated with brachialgia however the benefit of these injections is often only a temporary fix and can wear off after several days or weeks. However, I find that individual experiences vary greatly with the impact of any injections for sciatica and brachialgia. In severe cases of brachialgia surgery performed by a neurosurgeon, or spinal surgeon may be needed where previous treatment has failed to provide significant or lasting relief.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on What Is Brachialgia? should consult his or her general practitioner, physiotherapist or otherwise appropriately skilled practitioner.